Chapter 11: Psychological Therapies

Introduction Psychological therapy or psychotherapy describes any interaction between a patient (often referred to as a “client” in psychotherapy) and a trained individual in which specific techniques are used to help the patient overcome psychological problems such as depression, adjust to life situations like divorce, increase individual development (e.g., achieve career success), or improve compliance […]

Chapter 12: Schizophrenia Spectrum and Other Psychotic Disorders

Introduction to the Diagnostic and Statistical Manual of Mental Disorders This and the next six chapters of the book focus on mental disorders. Inclusion and diagnostic criteria for these disorders are based on a consensus of current opinions and concepts in psychiatry as described in the Diagnostic and Statistical Manual of Mental Disorders (DSM), a […]

Chapter 13: Depressive Disorders and Bipolar and Related Disorders (Mood Disorders)

Introduction Variations in mood are common in everyday life. People normally feel sad when they experience a loss or disappointment and feel happy when they anticipate or experience a positive event. In contrast, patients with primary mood disorders show discordance between life events and how they feel emotionally. There may be no change in their […]

Chapter 14: Suicide

Introduction A patient who wants to take his or her own life challenges a physician’s fundamental purpose. Although the reason for the suicide attempt may not be immediately apparent, people rarely reach this decision easily. In fact, most suicidal patients are ambivalent about their decision to kill themselves; they want to escape an intolerable life […]

Chapter 15: Anxiety Disorders and Related Disorders

Introduction A woman is approached by a strange man on a dark street. Her body responds rapidly. Her heart rate increases, she starts shaking and sweating, and she has an intense desire to run to safety. Another woman experiences the same sympathetic nervous system responses whenever she leaves her home, despite the fact that there […]

Chapter 16: Somatic Symptom (Somatoform) Disorders, Factitious Disorders, and Malingering

Introduction At least 30% of the physical complaints of primary care patients cannot be explained by organic illness [Kroenke et al., 1994]; [Kroenke, 2007]. Although understanding the social and psychiatric influences on these complaints is essential for appropriate management, patients with unexplained symptoms present a diagnostic and treatment challenge for even the most empathic and […]

Chapter 17: Obesity and the Eating Disorders

Introduction “You cannot be too rich or too thin.” This quote, often attributed to Wallace Simpson, the reed-thin American wife of the late Duke of Windsor, reflects the attitude of many Americans toward body weight. That is, they equate being thin with being successful, while being obese reflects laziness and lack of self-control. This idealized […]

Chapter 18: Neurocognitive and Dissociative Disorders

 Introduction A person who forgets his identity and turns out to be the long-lost heir to a fortune is the stuff of novels and movies. In the real world, amnesia (loss of memory) rarely has a romantic or exciting outcome. Two groups of disorders, the neurocognitive disorders and the dissociative disorders, are characterized by deficits […]

Chapter 19: Biological Therapies

Introduction Until the late 1940s, patients with serious psychiatric illnesses had few treatment options. They might have received insulin shock therapy, electroconvulsive therapy (ECT) (without anesthesia), or barbiturate or narcotic sedation. They almost certainly were confined for the duration of their illness to a secure institution where they may have been kept in physical restraints. […]

Chapter 20: Culture and Illness

Introduction A Chinese-American patient who has chronic heart disease is more likely to die on the fourth than on any other day of the month. This puzzling observation, called “The Hound of the Baskervilles Effect” because of a similar occurrence in the classic Sir Arthur Conan Doyle novel, is attributed to the stress provoked by […]